PB2566: EPIDEMIOLOGICAL PROFILE AND INDICATIONS FOR IV IRON THERAPY: A TRANSFUSION SPARING ALTERNATIVE
Authors: Amine Laabichi, Wafae Ammouri, Hasna Talebi, Naima Mouatassim, Naoufal Ben Lachgar, Soukaina Haidouri, Hajar Khibri, Hicham Harmouch, Mouna Maamer, Zoubida Tazi-Mezalek, Mohamed Adnaoui
Journal: HemaSphere (2023)

Topic: 29. Iron metabolism, deficiency and overload Background: Iron deficiency anemia (IDA) is a public health problem and is one of the leading causes of anemia, oral supplementation is its main treatment, with the cure of the underlying condition. Injectable iron therapy (IIT) represents a very interesting alternative, but its use is limited by its price, particularly in low- and middle-income countries. Aims: Describing the use of IIT in the Moroccan population Role de IIT as a transfusion-sparing alternative in the IDA and multifactorial anemia Methods: A prospective, descriptive single-center study, including patients referred for IIT to the daycare hospital of the internal medicine and clinical hematology department of the CHU IBN SINA, over a period of 4 months Results: We collected 43 patients, with an average age of 45.25 years (15-82), the sex ratio F/M is 5.14, and an obvious cause of the deficiency was found in the history of 23% of the patients (10). 14% (6) patients have already received a blood transfusion before. The symptoms reported by our patients are distributed in order of frequency: Asthenia 83.7% (36), Dyspnea 53.5% (23), Vertigo 48.8% (21), Pallor 44.2% (19), Phaneric disorders (hair loss, brittle nails) 30.23% (13), Palpitation 30.23% (13), Headache 27.9% (12), worsening of pre-existing cardiac angina 2% (1) Average Hemoglobin is 8.75 (4-13.4g/dl), average VGM 70.83 µm2 (46-95), average TCMH 21.61 pg (13.3-29.5), MCHC 30.14% (25-33.3), Ferritin 13.7 ng/mL (1-282). 67.44% of patients (30) have already received oral supplementation before, of whom 43.33% (13) in the form of ferrous sulfate, 23.33% (7) in the form of ferrous proteinsuccinylat, 10% (3) in the form of fumarat, and 10% (3) took several forms successively. The indications for IIT in this group of patients include: A response deemed insufficient to oral treatment in 34.88% (15), profound anemia (sparing transfusions) in 25.58% (11), poor digestive tolerance in 16.27% (7), neoplasia under chemotherapy with mixed anemia 4.6% (2), chronic renal failure 4.6% (2), ischemic heart disease 2.3% (1) and finally, the choice of the patient in 4.6% (2). In the “insufficient response to oral treatment” group, the mean duration of treatment was 4.46 months (1-12), with 20% of patients (3) having received treatment for less than 3 months. The choice between Ferric Carboxymaltose (CMF) and Sucrose and Iron Complex (SacchaFe) was made by patients economically stable after an explanation of their protocols and possible adverse effects respectively, for indigents patients, CMF was used systematically being the only form available in the hospital, 65.11% (28) received CMF, and 32.55% (14) received SacchaFe. Allergic adverse effects such as a rash or moderate pruritus were reported in 10.7% (3) of patients who received CMF, and 21.42% (3) who received SacchaFe, no serious reactions were reported. All patients with isolated IDA presented a good response with normalization of biological parameters after the 3rd week for very deep anemia, the response was less complete in patients with anemia of mixed causes. Summary/Conclusion: IIT represents a very effective and rapid means of correcting an IDA, in particular in fragile patients or the presence of malabsorption limiting the oral uptake of iron, its use as Transfusion sparing is also very interesting, limiting the exposure of patients to labile blood products. Our study represents a sample of our population in this context, other studies with a larger number of patients are needed for a more precise description Keywords: Iron, Ferritin, Iron deficiency anemia, Anemia